In my two previous posts, I discussed common mistakes made by horse owners and rescue responders during a large-animal technical rescues. This week, we talk about the veterinarian’s role in these situations. The following are three missteps veterinarians should avoid during an equine emergency.
1. Assuming that they should take the role of incident commander
Regardless of the type of emergency or disaster, all individuals and organizations involved respond under a common protocol known as the Incident Command System (ICS), and National Incident Management System (NIMS), under the National Response Plan (NRP).
The basic principles of the ICS are fully applicable to large animal incidents and include the following:
Planning: An incident action plan must be developed for every incident (simple and verbal, or complicated and written) depending on the size and length of response.
Team approach: Every responder acts as part of a team and knows his or her job.
One Coordinator: The incident commander (IC) coordinates the incident response; he/she is the leader and shoulders responsibility for the entire scene. This is normally a fire fighter or police officer who has extensive training and certifications in this area. This is what they do every day.
Span of control: One person can only coordinate the activities of five to seven responders.
Safety: Safety is the primary reason for the team approach for the victim and the rescuers.
No freelancing: Individuals responding/acting on their own constitute a risk and a liability to others on the scene. The IC has the authority to forcibly remove them from the scene.
In today’s world the equine practitioner is an emergency responder. Therefore, it is imperative for the practitioner and staff to understand and communicate using the emergency response “language” of ICS. The best online training source for the ICS is the Emergency Management Institute, under FEMA. There are different levels of ICS training that give the equine practitioner (or horse owner or volunteers) the basic qualifications to help respond in a local or national emergency/disaster of any size.
IS-100 Introduction to the Incident Command System and IS-700 National Incident Management System (NIMS), An Introduction, takes about four hours to complete online. In disaster situations, failure to possess this certification could result in dismissal from the response. In localized emergencies, it may result in failure to coordinate with the team. After taking a simple online test, anyone can receive a certificate of completion. (Other animal-related disaster content courses are available at through FEMA).
Emergency and disaster medicine are not the same thing and few veterinary schools have animal disaster response or technical emergency rescue and extrication as part of their curriculum. Happily, over the last 20 years several schools (Florida, Louisiana, Mississippi, North Carolina, California, etc.) have made a move towards providing their students with courses such as “The Role of the Veterinarian in Incident Command” or “Disaster Preparedness” and several also offer courses and specialty TLAER or LAR, VERT, DART, or SAR team training to their students.
In this photo, the veterinarian (wearing blue) works as the animal handler. Correct positioning allows the veterinarian to evaluate medical status and advise on horse behavior, ensuring the rescuers are safe and the patient is monitored.
2. Assuming that they should participate in the operational portion of the extrication
The importance of safety should be emphasized at all times, even using long-handled tools to emplace appliances on animals that may otherwise kick, bite, or crush us. If possible, a professional animal handler such as the veterinarian, the veterinary technician, or someone with large animal handling expertise should take over the animal handling job when they arrive. They are in the perfect position to advise the operational personnel about the medical status and potential behavior or reactions of the animal, as well as approach techniques and body position.
The veterinarian or their technician should handle the animal, but in many cases should not work the ropes, put on a Swiftwater PFD, pull on an assist device, or get down and dirty in the mud for technical rescue/extrications.
As discussed in my last post, Top 4 Mistakes Responders Make During Equine Emergencies, many animal owners are far too emotional to handle the animal during an emergency. On the other hand, veterinarians have good training in remaining calm, making rational decisions, and handling the animal professionally (so they and others don’t get injured, and that the animal doesn’t get loose). Additionally, most police and fire officers don’t have any horse experience; large-animal handling skills for emergency situations are a specialty skill set. Many officers might not have had exposure or training and might underestimate the extreme weight, strength, and speed of a terrified, trapped, or injured horse.
Whether it is a single incident (e.g. a trailer overturn on the road) or a large-scale disaster (e.g. wildfire), the veterinary practitioner is one member of a group of emergency responders. In the case of a single, smaller incident, local responders will include fire fighters, law enforcement, and possibly animal control and paramedics. In the case of both small and large-scale events, it’s essential for the professional practitioner to know how to interact and work as part of the team with other emergency response individuals from county, state, federal, and private emergency-response organizations.
3. Failing to treat the horse for accidental hypothermia immediately after the rescue/extrication
Horses get trapped in the mud, fall through surface ice, or land in swimming pools. In the case of hypothermia, prioritization of the rescue effort sometimes has fatal consequences. The animal is a medical patient, too, and might need treatment during the rescue effort to offset the metabolic changes that occur.
For example, once the equine victim is removed from the hypothermia-causing environment, misunderstood efforts to restore body temperature can be counterproductive, resulting in a more severe hypothermic state. The fact that the horse will stand and eat some hay after the rescue can be interpreted as a sign that the horse is OK, but the horse may die a few hours later. Even when a team completes an efficient rescue and veterinarians do treat the animal immediately, the animal can still die.
Risk Factors attributed to the onset and severity of hypothermia*
The following are are common reasons horses suffer from hypothermia during and after a rescue:
Dehydration—Most horses suffering from acute hypothermia also suffer from dehydration.
Poor body condition—Horses in poor body condition are more susceptible to hypothermia due to a reduced layer of insulating subcutaneous fat.
Age—The ability to generate heat decreases with age in all mammals studied.
Body surface/volume (mass) ratio—The larger the body surface relative to body mass, the more core temperature will be lost across the body surface. This explains in part why donkeys and small horses (foals, ponies) are more susceptible to hypothermia than larger horses.
Drugs—General anesthetics (anesthetic-induced vasodilation) sedatives will aggravate hypothermia.
Rough handling—Rough handling of the profound hypothermic patient after the rescue can trigger ventricular fibrillation and cardiac arrest.
* From “Accidental Hypothermia in the Horse” by Tomas Gimenez, DMV, TLAER, Pendleton, S.C.
Have you been involved in one of these situations?
Please contribute your stories and reactions. How did you contribute to a good rescue of a horse? You can send photos to firstname.lastname@example.org for later posting, and thank you for sharing.